ต้อกระจก และเลนส์แก้วตาเทียม
Cataracts
Did you know? Cataracts are the leading cause of blindness in Thailand.
What is a Cataract?
A cataract is a clouding of the eye's natural lens, which blocks light from reaching the retina. This results in blurred or "foggy" vision.
What Causes Cataracts?
- Mostly caused by age-related degeneration. Almost everyone aged 65 and older will develop cataracts to some degree.
- Congenital (present from birth).
- Frequent or prolonged use of steroids (oral or eye drops).
- Exposure to UV rays, X-rays, or infrared radiation.
- Eye trauma or electric shock.
- Complications from diabetes, glaucoma, or other underlying conditions.
How to Spot the Symptoms?
- Vision gradually and slowly becomes blurrier.
- Seeing halos or "glare" around lights, and experiencing double vision.
- Seeing better in the dark than in bright light; vision becomes very blurry when exposed to bright light.
- "Second sight" – suddenly being able to read books without glasses again as the lens changes shape.
How are Cataracts Treated?
The only effective treatment is surgery to remove the cloudy lens and replace it with an Intraocular Lens (IOL).
How to Prevent Cataracts?
- Wear sunglasses regularly to block UV rays.
- Have regular eye check-ups with an ophthalmologist if you are over 40 or notice any vision abnormalities.
Will Cataracts Go Away Without Surgery?
No, they will not.
Wearing sunglasses may help reduce blurriness in some patients. Measuring vision and wearing prescription glasses in the early stages can temporarily improve clarity, but it does not cure the cataract.
What are the Surgical Options?
There are two main methods:
1. Extracapsular Cataract Extraction (ECCE)
This is a traditional method involving a larger incision to remove the entire cloudy lens in one piece. A rigid IOL is then inserted. This method requires stitches, which can lead to astigmatism, and is not compatible with "Premium" multifocal or toric (astigmatism-correcting) lenses.
2. Phacoemulsification (Ultrasound)
This is a modern, high-safety technique using a tiny incision (2-3 mm). High-frequency sound waves break the cloudy lens into small pieces, which are then vacuumed out. A foldable (soft) IOL is then inserted. Vision recovers quickly, often by the next day, allowing for normal activities. This method supports Premium multifocal and toric lenses.
Is Cataract Surgery Painful?
Generally, ECCE (large incision) requires local anesthetic injection or general anesthesia. In contrast, patients undergoing Phacoemulsification usually feel no pain; it often only requires anesthetic eye drops instead of an injection.
What is an Intraocular Lens (IOL)?
An IOL is a permanent artificial lens implanted into the eye to replace the natural lens removed during surgery.
There are two types of IOL materials:
- Rigid IOL: Made from synthetic plastic (PMMA). These were the first types used, with a diameter of 5.0-6.5 mm, typically used for ECCE surgery.
- Foldable (Soft) IOL: These can be folded in half, making them ideal for Phacoemulsification because they can be inserted through a very small incision.
IOL technology has advanced significantly, effectively mimicking the natural human lens. Patients can not only treat cataracts but also correct pre-existing nearsightedness, farsightedness, and astigmatism, leading to rapid visual recovery.
Illustration of the eye and vision
How Many Focal Ranges Can an IOL Correct?
Modern IOLs are developed to correct multiple focal points, allowing for clear vision at both near and far distances.
Examples of Activities and Visual Distances
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Near Distance ~30 cm |
Intermediate Distance ~40-60 cm |
Far Distance |
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